Patho Study Guide 3

Nursing Pathophysiology with Dr. Pennington at Goldfarb School of Nursing

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By: Amanda Lutz
Created: 2011-10-25
Size: 66 flashcards
Views: 100

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Explain blood gas levels for acute respiratory failure

PO2 levels less than 50 with or without PCO2 levels greater than 50. PO2 is the amount of free oxygen in their arterial blood. That is only 3% of your total available oxygen. The CO2 number only measures about 7% of total available CO2. Free Floating.

Give five conditions likely to lead to respiratory failure

1. Hypoventilation-acidosis

2. Hyperventilation-alk

Explain the relationship of decreased ventilation of respiratory acidosis.

Pt only breathing 5x/minute CO2 and K levels go up. Hydrogen ions brought into RBC to get out of blood. H is positively charged, we want neutral. K comes out of RBCs to balance. Carbonic acid.

Explain renal compensation to respiratory acidosis.

Lungs have the most control over CO2. Kidneys pee off hydrogen and retain bicarbs.

Squamous Cell Carcinoma

Most common. Centrally located in bronchial tree. Slow growing malignancy. If diagnosed early it is easily cured. Symptoms: persistant, non-productive cough for a year.

Adenocarcinomas

Glandular epithelial tissue. Bad cancer to have. Very quick to invade lymph nodes, bones, and surrounding vessels. Not unusual for it to be diagnosed at metastisising site first.

Large Cell Malignancies

10-20% of lung cancers. Immature cells, reproduce rapidly.

Small Cell Malignancies

AKA Oat Cells. Youngest in malignancy, very aggresive, very quick doubling time. Less than 5% 5 year survival rate.

What is the causitive organism with pulmonary TB?

Mycobacterium - has a lot in common with fungus.

Tuberculin Skin Test

Tuberculin introduced under skin. Localized reaction proves antibody exists. Antibody means you have TB. You will be treated for 6 months to a year. You are probably not infectious, but your skin test will always be positive.

RBC Normal Blood Value

Males: 4.7 - 6.1 mm3

Females: 4.2 - 5.2

HgB Normal Blood Values

Males: 13.4 - 17.6

Females: 12.0 - 15.4 gm/100mL

HCT Normal Blood Value

Should always be 3X hemoglobin.

Males: 42 - 53%

Females 38 - 46%

MCV Normal Blood Value

Size of RBC. 81-96 mm3

MCHC Normal Blood Value

Amount of hemoglobin.

30-36 gm/100mL

White Blood Cell Normal Blood Value

4,000 - 10,000 mm3 total count. What type is more important than total number.

PMN Normal Blood Value

AKA Nuetrophil or seg. 38-70% of WBCs. Phagocytize bacteria. Elevated levels would mean bacterial infection.

Normal Eosinophils Blood Value

1-5%. Don't do much normally. Elevated with parasitic infections or allergic reaction. Histamine producing.

Normal Basophiles Blood Value

0 - 2% Little known.

Stab/Band Normal Blood Values

1-2%. Immature seg.

Mono Normal Blood Values

1-8% Largest of the WBC. Elevated in recuperative phases of infection, not during acute phase.

Lymph Normal Blood Values

15-45% Produces antibodies for viral infections.

Platelet Normal Blood Value

150,000 - 400,000 mm3

Reticulocte normal blood value.

Immature RBC. Normally 1 - 2%. Higher if bleeding.

Normacytic/normochromic anemia

Morophology - individual cells, normal size and color, indicate blood loss/loss of volume.

Macrocytic/normochromic anemia

Morphology - Larger cell with normal color. Classic with b12 and folic acid deficiencies.

Microcytic/hypochromic anemia

Morphology - smaller cell with loss of color/hemoglobin. Indicitive of iron deficiencies and chronic blood loss.

Explain etiology of anemia

Lack of productions, loss of RBCs

Aplastic Anemia

Normacytic/Normachromic. Hypoplasia to the bone, being replaced with fat. Disorder of bone marrow stem cells. Differentiates into RBCs/WBCs/Platelets. Hemocytoblast shuts down. Pancytopenia. From mustard gas, radiation.

Define Pancytopenia

"A lack of all cells" with Aplastic Anemia. Can be a side effect of antibiotics. Seen with mustard gas exposure, radiation.

Iron Deficiency Anemia

Microcytic/hypochromic. Signs are weak, tired, broken fingernails, tonge pale and smooth, hair frizzy with split ends. Kids can get from eating too much dirt.

Megaloblastic Anemia

Macrocytic/normachromic. b12 folic acid deficiencies. Cell membranes too big and flimsy, easily broken down. Treat b12 before folic acid.

Sickle Cell Anemia

Category of hemoglobinopathies. Genetic. Problems in joints. Protects against malaria.

Define relative polycythemia.

Polycythemia is too much blood. Relative: RBC 5.2, HgB 15g, HCT 68%. HCT is too high. Increase in rbcs or decrease in serum.

Define absolute polycythemia

RBC 8.2, HgB 23g, HCT 68%. Blood is very thick. Heart works harder, hypertrophies. RBC increase, iron increase. Free flowing iron is hepatoxic. Example of selling blood every week, then suddenly stopping.

Leukocytosis

Increased white count, relative

Esophageal dysphagia

Impairment of swallowing past the pharynx. May have after stroke or with cerebral palsy.

Esophageal spasm

Caused by cold temps. If diffuse, it happens with all cold or cool substances.

Chronic reflux esophagitis

Reflux inflames esophagus. Sometimes related to hernia. Stomach contents come back up into esophagus. Low pH, esoph tissue not equipped to handle. Burning sensation. Can erode hole, which would be emergency.

Haitus Hernia

Part of the stomach portrudes up into the esoph. When cardiac sphincter muscle is weak.

Gastritis

Inflammation of the gastric mucosal lining.

Acute superficial gastritis

The kind you get from eating spicy foods. Hurts for a while, repairs itself.

Chronic atrophic gastritis.

atrophy of glandular epithelial tissue in stomach. Gradually loses all secretion from stomach. More likely in elderly. Decrease in chief cells. More likely to develop gastric ulcers and stomach cancer.

Peptic Ulcer Disease

Breaks in the mucosal lining of the stomach or duodenum that extend through the basement membrane.

Where do most ulcers occur, and who is most likely to get them?

80% of peptic ulcers occur in the duodenum. 20% in the stomach. Mostly found in the anterior or posterial wall of the first part of the duodenum. Generally, young males get them.

Explain H. pylori's role in ulcers.

The bacteria grows below the mucosal lining of the stomach, where it is less acidic. As they grow,t hey secret a substance that neutralizes hydrochloric acid ahead of the growth.

What are the clinical signs/symptoms of ulcers.

Pain that goes away right after eating, but returns 2 - 3 hours later. Most severe pain when stomach is empty.

What are the complications of ulcers?

Intractability-pain in spite of treatment. 25% of ulcers hemorrhage. 5% of ulcers perforate. Requires emergency surgery.

Discuss common causes of malabsorption

Gastrectomy (small amt), Pancreatic problem, problems in the terminal iliium, heredity, decreases in vitamin B12 or intrinsic factor.

Define celiac disease and explain the role of gluten

Celiac disease is the atroph of villin in small intestine. Gluten foods can't be absorbed. People will have ongoing diarrhea. May be autoimmune disorder. May be genetic.

Explain lactose deficiency disease

Genetic. More likely in the african american population. Can buy the enzyme and consume before you eat dairy. Untreated: abdominal cramps, bloating, diarrhea. Occurs as you age.

Regional Enteritis.

Crohn's. Inflammatory disease of the small or large intestine. Found in terminal ileum 80% of the time. Skip lesions form b/c inflammatory response starts in submucosal layer, swells, pushes into mucosal layer and restricts flow.

Define appenticitis and give probable CBC values.

Most common in young adults. Inflammation causes it to get bigger and thinner. Rebound pain at McBurney's point. Pain can be similar to UTI.

How can you locate McBurney's point?

Draw a line from your right antierior superior iliac spine to our belly button. Half way is MB point.

Peritonitis

Inflammation of the peritoneum. Can be ruptured appendix, most common is puncture wound or exit site for organisms to get out of intestines into p. Very dangers b/c so vascular. Abscess forms, but continues to grow. Must treat with antibiotics.

Distinguish between non-mechanical and mechanical obstruction

Non-lack of peristalsis, nothing obstructing. Seen after abdominal surger. Mech-physical obstruction. Sml intestine is adhesion. Large intestine is tumor or cancer. obs feels like intestinal cramp, vomiting, diarrhea, pain around belly button.

Explain diverticular disease of the colon

Herniation of the mucosal lining through the muscular lining that causes a saculous. Diverticulitis is inflammation. More likely to develop as you age. Mostly in sigmoid colon. Correlated with lack of motility in the colon and lack of roughage.

Define ulcerative colitis and discuss etiology.

Non-specific inflammator disease of the colon. It runs in the family and happens to short tempered people. There are leasions to mucosal layer. 20-40 years of age.

List 3 common clinical types of ulcerative colitis.

Acute fulminating (less) acute onset, bloody diarrhea, n/v, deadly.

Chronic intermittent, slower onset, 3 months of diarrhea, vomitting fever, then recover, followed b onset.

Chronic continuous, most common. Not severe, but ongoing.

Polypoid adenomas

Affects 7-10% of people over 45. Benign. Sigmoid to rectum.

Vallous Adenoma-25% liklihood for malignancy.

FAmilial polyposis- most rare, runs in the family. 100% malignancy. Occur at puperty. Removed, but keep returning.

Where do 50% of bowel cancers occur?

Rectosigmoid portion.

What's the second most common site of stomach cancer?

Cecum

What's the 3rd most common site of stomach cancer?

Ascending colon.

What are the clinical features of colon cancer?

Change in bowel habits, bleeding, pain, anemia, anorexia, decrease in weight.

Define hemorrhoids defining etiology

Varicose veins in the rectom. Constipation and diarrhea, pregnancy, enlarged protstate, large uterine fibroids, liver enlargement all decrease pelvic venous blood flow, causing veins to elongate and dilate.

About this deck

By: Amanda Lutz
Created: 2011-10-25
Size: 66 flashcards
Views: 100

About StudyBlue

“Simply amazing. The flash cards are smooth, there are many different types of studying tools, and there is a great search engine. I praise you on the awesomeness.”
Dennis